老年股骨颈骨折的住院费用分析

The analysis of hospital expense in elderly people with femoral neck fracture

目的通过统计我院近6年932例股骨颈骨折住院患者的治疗方式与住院费用结构,充实我国老年股骨颈骨折治疗费用资料。方法收集广东省中医院的骨科患者资料,对2004至2009年中50岁以上的股骨颈骨折患者的一般情况、住院时间、治疗方式及住院费用进行统计分析。结果 6年中股骨颈骨折女性患者明显多于男性,男女患者总人数比为1∶2.57,平均住院天数为(22.74±14.12)d,人均总费用为(29835.14±15332.82)元。人工关节置换术占所有治疗方式的73.4%,人工股骨头置换的年龄明显高于全髋置换,但平均住院费用低于全髋置换。2005—2009年股骨颈骨折平均住院天数无明显变化,人均住院费用平均年增长速度为5.41%。从住院费用的构成比例上看,治疗费(包括手术材料费及内置物费)占61%,药费占17%,手术费占7%,检查费占3%,床位费、化验费及其他费用各占4%。结论人工关节置换是股骨颈骨折治疗的主要方式,所需医疗费用逐年递增(除2004年),有效控制内置物、手术器械费以及药费是减少老年股骨颈骨折医疗费用,节约医疗资源,减轻患者经济负担的有效的途径。

Objective To enrich the data of hospital expense for femoral neck fracture through the analysis of the therapy and cost structure of 932 femoral neck fracture patients in our hospital in last 6 years.Methods The medical records of patients who were over 50 years old and with femoral neck fracture were collected in the Chinese Traditional Hospital of Guangdong from 2004 to 2009.The general situation,the length of stay,treatment methods,and hospitalization expense of these patients were analyzed statistically.Results Female patients were significantly more than male patients,and the female to male ratio was 1∶2.57.The average hospital stay time was 22.74±14.12 days.The average cost per person was 29835.14±15332.82 yuan.Arthroplasty was performed in 73.4% patients.The age of patients treated with femoral neck arthroplasty was significantly older than that of the patients treated with total hip arthroplasty.However,the average cost of patients treated with femoral neck arthroplasty was less than that of patents treated with total hip arthroplasty.The average hospital stay time of femoral neck fracture did not change from 2005~2009.The average cost per person elevated 5.4% annually.The proportional structure of the cost showed that the treatment cost counted for 61%,medicine 17%,operation 7%,examination 3%,beds,test,and other cost 4%,respectively.Conclusion Arthroplasty is the main treatment method for femoral neck fracture.The hospitalization cost increases along with year（expect for 2004）.The effective control of the use of built-in materials,the cost of surgical apparatuses,and the medicine cost can effectively decrease the medical cost,save the medical resource,and reduce the economic burden of the patients.